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General NPI Number Information
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NPI Number | 1619042496
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Entity Type | Organization
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Legal Business Name | THE ADD CENTER OF WESTERN MASSACHUSETTS
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 155 MAPLE STREET SUITE 203
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City | SPRINGFIELD
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State | MA
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Zip | 01105-1828
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Country | US
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Telephone | 413-734-2800
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Fax | 413-739-1652
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Provider Business Mailing Address
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Address Line | 155 MAPLE STREET SUITE 203
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City | SPRINGFIELD
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State | MA
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Zip | 01105-1828
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Country | US
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Telephone | 413-734-2800
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Fax | 413-739-1652
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Authorized Official
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Title or Position | PRESIDENT DIRECTOR
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Name | MITCHELL I CLIONSKY
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Credential |
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Telephone | 413-734-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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